The difficult decision has been made to move forward with nursing home placement for your loved one. Once a suitable nursing home has been chosen based on your visitation of facilities and reviews and data such as can be found on Medicare.gov, you may wonder when to begin the process of qualifying financially and applying for Medicaid to help pay for the nursing home costs and protect your loved one’s hard-earned savings. The answer is usually “immediately”.
If your loved one is being admitted to the nursing home following a hospital stay, then Medicare may provide for up to 100 days of “skilled nursing care”; the first 20 days are covered 100% by Medicare, followed by days 21 through 100, which incur a daily copay of $194.50 (rate as of 2022, with the daily copay rate changing every year, and is often covered by an individuals’ Medigap insurance). Once the Medicare coverage ends, then your loved one will owe the private pay rate at the nursing home. According to SeniorLiving.org, the median annual cost of a semi-private room in an Indiana nursing home in 2022 is $86,688 and increasing every year.
If your loved one is being admitted to the nursing home without having first been admitted to a hospital, then he or she will be required to pay the full private pay rate from day one.
Your loved one will not be eligible for “nursing home” Medicaid until he or she meets certain income and asset requirements and is a resident of a nursing home that accepts Medicaid. Since many nursing homes will only accept patients who can pay for their care, and one cannot become eligible for Medicaid until he or she has been admitted to a nursing home, this creates a bit of a predicament.
Since there are legal ways to protect your loved one’s assets while qualifying for Medicaid even at the late stage of needing to be done immediately, or even after admission to a facility or a client has been private paying for months, or even years. It is important to promptly discuss options with an attorney who specializes in such planning. I have a team of four at my office whose sole focus is to assist clients through the entire Medicaid eligibility process for Indiana residents, from beginning to end. Call 812–423-1500 to schedule a free consultation to discuss your loved one’s planning options.